Exercise Recommendations for Angina & Silent Ischemia Physical activity & other lifestyle recommendations, along with revascularization & medications work synergistically to help reduce or eliminate the symptoms of angina. Moderate behavioral modification may also slow progression of, & in some cases regress,  atherosclerosis. The following exercise guidelines are evidence-based to help prevent coronary artery disease (CAD).

Aerobic/Cardiovascular Exercise


  • Improve functional capacity
  • Decrease CAD risk factors
  • Decrease Blood pressure response to submax exercise
  • Decrease myocardial oxygen demand

How often? How long? How challenging?

  • 3-7 days/week for 20-60 minutes including 5-10 minutes of a warm-up & cool-down period
  • Heart rate should remain 10-15 contractions below ischemic threshold

Strength Goals: Improve functional capacity How often? How long? How challenging?

  • 2-3 days per week for 15-20 minutes/session
  • Use light resistance to begin (40-50% of maximal contraction capacity)

Flexibility Goals: Decrease risk of injury by increasing range of motion (ROM) 2-3 days/week

Special Considerations

Anyone who has been diagnosed with angina should understand their unique situation & symptoms, be able to identify factors that could exacerbate symptoms, know how to treat angina (perhaps with nitroglycerin, if recommended by their physician) & be aware of their upper limits of exercise.

The effects of medications on heart rate, blood pressure & exercise capacity should all be considered when designing or participating in a physical activity program.

Participants should contact their physician if there are changes in the frequency, type or severity anginal symptoms, before, during or after exercise.

If angina develops during exercise, the participant should stop immediately, be administered sublingual nitroglycerin according to recommended guidelines.

A warm-up & cool-down period of 10 minutes or more has been shown to reduce the onset of angina.

Most importantly, everyone must listen to their bodies & take manageable steps everyday to improve their overall wellness & functional ability to enjoy an abundantly healthy life!